community health worker advisory body (chwab)
TRANSCRIPT
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Meeting Agenda
1. Welcome & Introductions
2. Establish CHWAB governance
3. Review & Discuss training requirements
4. Review and approve internship program recommendations
5. Discuss design groups
6. Certification application update
7. Next steps
8. Adjourn
CHW Advisory Body
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CHWAB Membership
CHW Employing Agency
Lee Carenza
Milagrosa Seguinot
CHW Association of CTJean K. Jacob, PharmD
Healthcare Provider
DPH Appointee
Chris Andreson Erika Lynch
Community College
Community-based CHW
training organization
Michele Scott
Dr. Tekisha Dwan Everette
CHWAB Chair
Adriana Rojas
Healthcare Employer
Mildred Landock
Bianca Noroñas
DeLita Rose-Daniels
Jerry Smart
Nilda Paris
Derricia Parker
Community Health Workers
CHWAB Support
Vicki Veltri
Stephanie Burnham
Dashni Sathasivam
Jeannina Thompson
CHWAB Governance
Appointing a CHW co-chair for the CHWAB
Criteria:• Pending CHW certification
• Demonstrated ability to:
• Facilitate CHWAB meetings in Tekisha’s stead
• Send communications on behalf of the CHWAB
• Attend meetings in-person
• Attend monthly meeting planning calls with CHWAB support team
Appointment: Occur prior to the next meeting
Interested CHW CHWAB members should email Steph & Dashni by
Thursday, December 12th, 2019
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CHWAB Governance
Governance proposal
The CHWAB will operate on a cooperative (majority votes), as is typical of OHS
groups.
Quorum: The minimum number of voting CHWAB members need to be present
(in person and via phone) at a meeting to make decisions.
CHWAB quorum: At least 7 people (50% + 1)
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Today’s meeting priorities:
• Training program
• Minimum number of hours
• Training modality
• Instructor qualification
• Assessment
• Internship requirements
• Length of internship
• Training provider and Host Agency requirements
• Internship supervision
• Internship goals
• Learning objectives
• Assessment of knowledge and skills
• Evaluation
• Tools and Materials
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Recommendations CHW Training Program Requirements
Program Duration
Recommendation: Training programs should include 90 hours of
training and an internship with a minimum of 50 hours.
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Recommendations CHW Training Program Requirements
Program Content
Recommendation: The content of training CHWs should consist of the
core skills and services utilizing the Community Health Worker
Consensus Project (C3) Core Competencies.
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Recommendations CHW Training Program Requirements
Key Considerations:
The Committee accepted a modified version of the C3 Core
Competencies (See Appendix B), which were previously discussed and
accepted as the key CHW roles and skills by the CHW Advisory
Committee in the 2017 Report (pg. 12, para. 1-2, Table 1).
The C3 Core Competencies were developed as part of the CHW Core
Consensus Project which, in 2014, brought together national experts to
establish core elements of CHW Scope of Practice and Competencies.
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Recommendations CHW Training Program Requirements
Roles1. Conduct outreach
2. Provide culturally appropriate health
education & information
3. Care coordination, case management, and
system navigation
4. Provide coaching and social support
5. Advocate for individuals and communities
6. Build individual and community capacity
7. Provide direct service
8. Cultural mediation among individuals,
communities, & health and social service
systems
9. Implement individual and community
assessments
10. Participate in evaluation and research
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Skills1. Communication
2. Interpersonal and relationship-building
3. Service coordination and navigation
4. Capacity building
5. Advocacy
6. Education and facilitation
7. Individual and community assessment
8. Outreach
9. Professional skills and conduct
10. Evaluation and research
11. Knowledge base
Recommendations CHW Training Program Requirements
Modality
Recommendation: Training modality and methodology should follow
Adult Learning Principles, include role-playing, and be interactive.
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Recommendations CHW Training Program Requirements
Key Considerations
The CHW Advisory Committee discussed different types of training
modalities and methodologies. They took into consideration guidance
from national CHW expert Carl Rush that CHW education be based on
adult learning principles.
The Committee felt it was critical that training programs be participatory
in nature, focus on empowerment, popular education, and IBEST
(integrated basic education skills training). They further recommended
against lecture and quiz formats.
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Recommendations CHW Training Program Requirements
Modality
Recommendation: Training should be delivered in-person or utilize a
hybrid approach that includes in person sessions and distance learning
in “real-time.” Online training alone should not meet the requirements of
certification. At least 40% of the hours of instruction should be taught or
co-taught by faculty who are Community Health Workers.
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Recommendations CHW Training Program Requirements
Key Considerations
• With so many options for online education and training now available, the Committee discussed whether
online training modalities would be sufficient for CHW training programs. They considered online, in-
person, and hybrid training programs. The Committee took into consideration guidance from national
CHW expert Carl Rush who indicated that in-person training for CHWs is always best, independent
online learning is not recommended, and hybrid and interactive TV modes can work well,
especially to meet the needs of smaller states and rural areas.
• The Committee favored in-person training programs that offer interactive, person-centered
activities like role-play and role modeling. However, they determined that hybrid models offer
opportunities for potential CHWs who may not be able to commit to a fulltime in person curriculum. Such
options may be especially important in rural areas. Furthermore, online education has transformed in
recent years to provide more “real-time” interactive components that could be beneficial to potential
CHWs.
• The Committee reviewed the requirement from Massachusetts requiring that at least 40% of the hours
of instruction shall be taught or co-taught by faculty who are CHWs or Community Health Worker
Trainers. They chose to adapt this requirement by removing “or Community Health Worker Trainers.”
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Recommendations CHW Training Program Requirements
Instructor qualifications
Recommendation: Instructors for CHW training should be inclusive of CHWs with experience in
the field, as well as non-CHWs who meet the requirements of the training vendor. Instructors
should demonstrate past experience training individuals who provide community health work
services, including, but not limited to: Promotores, CHWs, or other health care professionals and
paraprofessionals in the previous six years. They should have the knowledge, skills and
competence to effectively teach a CHW Core Competency curriculum.
• Instructors who are not CHWs should provide a resume to demonstrate their experience
training in the past six years. Other requirements may additionally be defined by the training
vendor (i.e. educational background).
• Instructors who are CHWs should have at least three years of experience working full-time as
a CHW, proof of completion of a CHW Core Competency Training, and knowledge of group
facilitation.
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Recommendations CHW Training Program Requirements
Key Considerations• Instructor qualifications varied from state to state.
• The Committee looked at instructor qualifications in-depth for Massachusetts, Michigan, and
Texas. Michigan’s CHW Training and Instructor training is done by MiCHWA, which is a
stakeholder coalition that serves as the hub for CHW information for the state. Since this is not the
model for CT, the committee decided to focus on Texas and Massachusetts
• Texas requires that instructors are certified by the Department of State Health Services by one of
two ways. Must be a Texas resident who is at least 18 years old and (1) completion of an approved
160-hour competency-based Community Health Worker Instructor training program certified by
DSHS. Or (2) Experience – At least 1000 cumulative hours of experience training individuals who
provide community health work services including promotores, community health workers, and
other health care paraprofessionals and professionals in the previous six (6) years.
• Connecticut currently does not have the infrastructure built for Community Health Worker
Instructor training program and liked Texas’s experience requirement.
• Massachusetts just asks what the trainers experience is teaching the CHW core competencies.
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Recommendations CHW Training Program Requirements
Assessments
Recommendation: Assessments of successful training completion
should utilize (1) pre- and post-tests, (2) skills assessment, and (3)
include a capstone project or portfolio, or a combination of the two.
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Recommendations CHW Training Program Requirements
Key Considerations
• The Committee agreed that there should not be just a test to
assess CHWs.
• The Advisory Committee reviewed different types of assessments and
reviewed how CHW training programs in Connecticut are currently
assessing CHWs in their training programs. The Committee agreed
pre- and post-tests were effective and that there should some
assessment of skills, but did not define a specific type of
assessment method, feeling that each training program provides
ongoing assessments throughout the training.
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Overview of CHW Internships
An internship should be an opportunity for the CHW to observe and practice core CHW
skills and services in the field, and to receive additional training, supervision and
feedback from professionals working in the public health, health care, non-profit and
community settings. (SIM, 2018)
Students who have completed CHW Core Competencies training from an approved
provider are required to complete internships with a local employer partner such as a
health center, hospital, public health department or community-based non-profit
agency.
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Overview of CHW Internships
Each site will have a formal agreement with the training provider that outlines
responsibilities for the agency including supervision of interns and the assessment
process. Students negotiate individualized learning objectives that fit their own career interests
and the mission and services of the agency. CHW interns will be encouraged to focus on
practicing and enhancing 3-4 key CHW skills on their internship, such as:
• Providing community-based health outreach services• Co-facilitating a support or educational group along with an agency colleague• Developing new health education materials or presentations• Co-facilitating a training or workshop on a designated health topic• Providing initial client-interviews or intakes• Supporting clients with chronic disease management, such as the development and implementation
of an Action Plan for Self-Management• Providing client-centered case management services• Participating in the development and/or implementation of a survey or community diagnosis designed
to gather information from the communities served by the agency• Participating in a community-organizing or public policy initiative or project
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Recommendations CHW Internship Requirements
Length of internship:
Recommendation: Minimum of 50 hours over a period of six months,
with option for extension based on circumstances.
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Recommendations CHW Internship Requirements
Key Considerations:
• The recommendation for a 50-hour internship resulted from research conducted
with states that currently certify CHWs. The recommendation aligns with Rhode
Island’s 50-hour requirement for an internship. Kentucky, Missouri and Ohio
have more rigorous internship requirements with 80, 60 and 130 hours respectively.
• For the internship to be a valued, capstone experience, not just a requirement or
obstacle on the way to certification, length needs to be significant.
• To ensure sufficient focus and intensity of the experience, the duration of the
internship should be no more than six months, and preferably over a shorter
period, i.e. 50 hours over a six month period translates to approximately two hours
per week—an insufficient amount of time for a meaningful experience for the intern
or the host agency.
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Recommendations CHW Internship Requirements
Internship Host Agencies:
Recommendation: Provider of CHW training is primarily responsible for recruiting and
coordinating local internship sites; Potential sites include Health centers, FQHCs,
hospitals, healthcare practices, public health departments, school-based health
centers, libraries or community-based non-profit agencies; Students may also identify a
site, including with current employers, to be approved by CHW training provider; If site
is with current employer, additional tasks, a project or program must be agreed upon
and included in contract/agreement.
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Recommendations CHW Internship Requirements
Supervision
Recommendation: Required at internship site, CHW preferred as
supervisor; Orientation for supervisors of internships to conducted by
CHW training organization; Continuing Education credits may be
awarded to CHW supervisors for a) orientation/training and
b) supervision hours; Determine equivalency through research on other
states.
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Recommendations CHW Internship Requirements
Goal of Internship
Recommendation: Demonstrate knowledge and perform entry-level
CHW skills with professionalism and within ethical boundaries and
scope of practice
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Recommendations CHW Internship Requirements
Learning Objectives
Recommendation: Host agency, training organization and CHW intern
will agree on individualized learning objectives that fit intern’s career
interests and the mission and services of the agency; Provide a list of
sample learning objectives as a resource.
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Recommendations CHW Internship Requirements
Knowledge/Skills Assessment
Recommendation: Internship host agency and intern will select three to
four skills/competencies to assess during internship; CHW interns will
self-assess and supervisor will also assess. .
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Recommendations CHW Internship Requirements
Key Considerations:
• Intern assignments should add value to the services provided by the sponsoring
organization, and not just help cover routine needs (like the stereotype of “the intern” fetching
coffee). Signed agreement template should be developed incorporating learning objectives.
• Documentation: should include a report, presentation or portfolio including reflective
assessment of learning experience. This is an integral part of both learning and assessment.
• Regular meetings with both “academic” advisor and preceptor should be required, e.g. bi-
weekly contact at least by phone. The student’s assignment should include critical thinking
on how services of the sponsoring organization can be improved, from the point of
view of a client/patient advocate. Their thinking should not be limited to what they
individually are doing.
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Recommendations CHW Internship Requirements
Evaluation
Recommendation: Robust evaluative process of the internship
program with a standardized format to be developed by OHS
oversight/umbrella entity will be needed to fine-tune structure; Training
provider organizations have primary responsibility for evaluation with
reporting to OHS oversight entity; Feedback and data will be needed
from CHW interns, CHW training organizations, CHW supervisors and
host agency sites; Initial focus on process evaluation; Training provider
organizations may add additional questions to standardized evaluation
format.
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Recommendations CHW Internship Requirements
Key Considerations:
• Internship Supervisor should be asked to evaluate the CHW’s
performance in meeting the terms of the learning objectives halfway
through the internship placement (at “midterm”) and at the end of the
internship. These evaluations are confidential and submitted directly
to training provider organization.
• Students evaluate their own performance at the end of the internship,
as well as evaluating the internship placement site
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Recommendations CHW Internship Requirements
Tools and materials
Recommendation: OHS oversight/umbrella entity to provide web-
based access to online toolkit and materials for organizing managing
CHW internships; Tools and materials to include description of
internship process, sample contracts/agreements, skills/competencies
selection and assessment forms.
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Recommendations CHW Internship Requirements
Key considerations for tools:
• It should be made clear that the cells in the table must include descriptive standards
for each level of performance on each criterion, and not simply a subjective numeric
score.
• Rubrics need to include requirements that demonstrate application of lived
experience and not just classroom learning.
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Overview of design groups
• Smaller time-limited working group (3 – 5 people) with a singular focus
appointed or designated by the CHWAB
• Can be reconvened in the future as needed
• May require additional time commitment to research and make
recommendations to the larger advisory body.
• Generally, participation is open to the public to provide the opportunity for
other voices to be heard
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What design groups are needed?
• Outreach & Marketing
• Connecticut CHW Code of Conduct
• Personnel committee (appoint individuals to sub-committee or design
groups)
• Training vendor requirement
• Evaluating CHW certification
• Other suggestions?
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Certification Application Update
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CHW Application is live:
https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/Community-Health-Worker/Certification-
Requirements
Looking forward
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Next meeting:
January 2nd at the CT Behavioral Health Partnership in Rocky Hill
from 10 – 12pm
Upcoming meeting priorities:
• Training program requirements
• Training vendor approval process
Contact
Tekisha Dwan Everette: [email protected]
Stephanie Burnham: [email protected]
Dashni Sathasivam: [email protected]
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